What are the responsibilities and job description for the RN Utilization Management & Review Specialist position at OSF HealthCare?
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Pay range for this position is $34.25 - $51.13/hour. Actual pay is based on years of licensure. This is a Salaried position.
Overview
POSITION SUMMARY: The Utilization Management and Review Specialist (UMR Specialist) evaluates patient care and activities against objective criteria in an effort to take a proactive approach in addressing appropriate admission status of each patient. In addition the UMR Specialist will identify utilization issues involving under or over utilization of services, resolves and/or refers utilization issues in accordance with established procedures. Reviews medical records to determine appropriateness and medical necessity of admission and hospital stay and use of ancillary services.
Remote: This has the potential to be a fully remote-working position after 6 months of training and at the discretion of leadership. This nurse must live within traveling distance of an OSF facility.
Qualifications
REQUIRED QUALIFICATIONS:
- Education: Bachelor's Degree in Nursing must be obtained within 3 years of date of hire into role.
- Experience: 2 years of clinical experience in an acute care or managed care setting
- Licensure/Certifications: Current state license as Registered Nurse (IL)
- Other skills/knowledge: Working knowledge of clinical EMR system
PREFERRED QUALIFICATIONS:
- Education: Bachelor's Degree in Nursing
- Other Skills/Knowledge: Working knowledge of Microsoft Office applications
OSF HealthCare is an Equal Opportunity Employer.
Salary : $34 - $51